Mediastinal Lymph Node Dissection

Mediastinal Lymph Node Dissection (MLND) is the surgical procedure that involves examination and excision of the lymph nodes found in the central region of the chest between the lungs. Lymph nodes are bean-shaped structures that are part of the body's immune system. They help filter fluid in the body (lymph) for harmful cells or substances. 

These lymph nodes are very significant in the human immune system and are often associated with ailments such as lung cancer and other chest diseases. MLND assists physicians in making the proper diagnosis of disease, its stage, and the most efficient treatment.

At Gleneagles Hospitals, Mediastinal Lymph Node Dissection is performed by highly skilled professionals using modern surgical techniques to ensure safe outcomes and individual attention.

Mediastinal Lymph Node Dissection refers to a surgical operation whereby the lymph nodes found in the mediastinum are removed carefully. These lymph nodes can either be infected, inflammatory or even cancerous, particularly lung cancer.

The process enables doctors to determine whether a condition has spread to another area. The information is also essential for deciding on further treatment, including surgery, chemotherapy, and radiation therapy. MLND is regarded as one of the most reliable ways of staging lung cancer correctly.

Why Is Mediastinal Lymph Node Dissection Needed?

Mediastinal lymph nodes are often the first place where lung cancer spreads. The elimination and examination of these nodes help doctors determine the severity of the disease.

Key Reasons for MLND:

1. Accurate Staging: Since the lymph nodes are often where the cancer spreads, it helps determine the exact stage (phase) of the tumour.
2. Prevent Metastasis: This eliminates lymph nodes that contain cancerous cells, preventing their further propagation in the body.
3. Improved Outcomes: Complete dissection has been demonstrated to enhance survival rates, especially in non-small cell lung cancer (NSCLC).
4. Guide Treatment: The correct staging to make the appropriate decision regarding additional interventions such as chemotherapy or radiation (adjuvant therapy).
5. Complete Resection: This is necessary to achieve a potentially curative, complete excision of the cancer.

Before Mediastinal Lymph Node Dissection, patients undergo an extensive assessment to ensure safety and readiness.

This includes:

• Medical history review and physical examination.
• Imaging tests such as CT scans or PET scans.
• Blood tests and tests of lung and heart function.
• Discussion concerning existing medications.

Before the surgery, the patients can be recommended to quit smoking, avoid certain medicines, and observe fasting. Support and explanations are also supported emotionally, which reduces anxiety.

MLND is a procedure performed by a qualified team of surgeons under general anaesthesia. The precise method will vary based on the patient's condition and whether the surgery is performed in isolation or as part of a lung surgery.

Common approaches include:

• During lung cancer surgery, lymph nodes are removed while the surgeon operates on the lung
• Minimally invasive techniques: Specialised instruments and small incisions may be employed to reduce the time required to recover.

The surgeon takes great care to remove lymph nodes from certain parts of the mediastinum during the procedure. These samples are then forwarded to a laboratory for detailed examination. The operation is carried out with accuracy to ensure that nearby organs, such as blood vessels, nerves, and lungs, are not affected.

The patients who undergo Mediastinal Lymph Node Dissection are monitored very carefully in a recovery area after the operation. The recovery usually includes:

• A hospital stay of a few days, determined by the surgical method used.
• Discomfort management with painkillers.
• Lung maintenance with pulmonary breathing exercises.
• Gradual return to normal activities.

The majority of patients do recover well, particularly those with minimally invasive procedures. The medical staff explains very well how to care for the wound, the intensity of activities, and the subsequent visits. When the lab reports have been delivered, physicians review the results and clarify the next course of action, if necessary.

The key benefits of MLND include:

• Accurate diagnosis and staging of lung cancer.
• Better treatment planning.
• Avoidance of unnecessary therapies.
• Improved long-term outcomes.
• Peace of mind through clear answers

MLND is a reliable and detailed source of information that facilitates the process of informed decision-making and personalised care.

MLND has its risks, as with any surgical procedure, but it is difficult to have serious complications with well-experienced teams. Possible risks include:

• Nerve Injury: Lesion of the recurrent laryngeal nerve (impacting voice) or vagus nerve (impacting heart/digestion).
• Lymphatic Complications: The leakage of lymphatic fluid is one of the repercussions of the thoracic duct injury.
• Fistulas: There is a possibility of the occurrence of bronchopleural fistula (leak of air from the airway) and tracheoesophageal fistula (abnormal connection between the airway and oesophagus) in that order.
• Bleeding: It means more frequent blood transfusions due to greater blood loss.
• The surgical procedure will take longer.
• Cardiac Issues: Disruption of lymphatic circulation around the heart may lead to myocarditis, necrosis, and heart failure.

Gleneagles Hospitals is renowned for its proficiency in advanced cancer and thoracic treatment. A comprehensive patient-centred approach is also beneficial to patients.

• Multidisciplinary Expertise
  A thoracic team of surgeons, oncologists, pulmonologists, anaesthetists, and specialised nurses is working together to achieve the best results.
• Advanced Surgical Techniques
  The hospital employs modern, minimally invasive approaches when necessary, which help reduce pain and accelerate recovery.
• Comprehensive Diagnostic Support
  Cutting-edge imaging and pathology services will deliver precise, timely outcomes.
• Personalised Patient Care
  All the patients undergo customised treatment regimens, emotional assistance, and clear communication in the course.

Mediastinal Lymph Node Dissection is a significant procedure that is crucial for the diagnosis and management of lung cancers and other chest diseases. It assists physicians in providing appropriate treatment at the right time by providing accurate staging and invaluable insights.

Choosing a reputable hospital such as Gleneagles Hospitals always ensures you receive skilled care, utilise cutting-edge equipment, and enjoy your stay. The right medical aid helps patients proceed with confidence, clarity, and hope.